Naloxone take-home kits (THKs) are becoming available to the public and laypersons, and there are more programs being established providing these kits as well as corresponding education on proper use and signs of opioid overdose (McDonald & Strang, 2016). The authors clearly delineate the definition of prison release and hospital discharge as well as the process of determining ORDs. Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. However, this was not feasible to have an equal control and experimental groups as it would be unethical to withhold naloxone from future agencies that wanted to distribute naloxone to at-risk clients. The initial search yielded 118 articles that were reduced to 68 once all duplicates were removed. This study had a similar limitation to other studies in that it was difficult to obtain accurate follow-up data because they were self-reported. Naloxone perspectives from people who use opioids: Findings from an ethnographic study in three states. Among the studies included, the sample sizes ranged from 24 to 2,912, globally including the United States, Canada, the United Kingdom, and Germany. Wheeler E, Jones TS, Gilbert MK, Davidson PJ; Centers for Disease Control and Prevention (CDC). Prescription opioid misuse, heroin, and fentanyl. (2017), prisoners with a history of heroin use are at a higher risk for overdose after prison release within the first 4 weeks, as also reported in the work of Bird et al. Both primary and secondary outcomes were evaluated before and after 3-year periods. In synthesizing the above results of this systematic review, the effectiveness of these naloxone THKs, as a product used in preventing fatal overdoses, can be viewed as decreased mortality rates, increased successful opioid reversals due to use of naloxone, or increased survival rates. There were 1,685 participants randomized between May 28, 2012, and December 8, 2014. Connect with us on Facebook, Twitter, Linkedin, YouTube, Pinterest, and Instagram. USA.gov. Results: Study results were then synthesized, qualitatively, and within the current research, there is overwhelming support of take-home naloxone programs being effective in preventing fatal opioid overdoses. Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids-Conception and maturation. 7. 2017 Mar;69(3):340-346. doi: 10.1016/j.annemergmed.2016.07.027. Magwood O, Salvalaggio G, Beder M, Kendall C, Kpade V, Daghmach W, Habonimana G, Marshall Z, Snyder E, O'Shea T, Lennox R, Hsu H, Tugwell P, Pottie K. PLoS One. Epub 2017 May 25. The final two outcomes the authors wanted to examine were how overdoses were managed with the use of naloxone versus how overdoses were managed without the use of naloxone (Bennett & Holloway, 2012). Clipboard, Search History, and several other advanced features are temporarily unavailable. The purpose of this systematic review was to determine if programs that supply take-home naloxone are effective in preventing fatal overdoses among those who abuse opioids. Randomized controlled pilot trial of naloxone-on-release to prevent post-prison opioid overdose deaths. The authors of this systematic review included 22 observational studies gleaned from PubMed, MEDLINE, and PsycINFO. Kestler A, Buxton J, Meckling G, Giesler A, Lee M, Fuller K, Quian H, Marks D, Scheuermeyer F. Ann Emerg Med. Exclusion criteria consisted of articles that contained studies with buprenorphine, emergency room naloxone administration, and/or methadone; reporting of only educational programs for opioids not specific to Narcan or naloxone; or where statistical data of opioid use or epidemic are not related to reduced mortality. The researchers were then able to calculate a proportion of use, which is needed for public health planners when determining resource allocation in regard to people who use drugs. It is an opioid antagonist. doi: 10.1097/JXX.0000000000000371. One limitation of this descriptive meta-analysis and systematic review is that it is noted to have a lack of randomized controlled trials partly due to ethical concerns. As a result, there is an implication for a practice change that take-home naloxone programs should be more widely implemented throughout communities as a method of decreasing mortality associated with opioid overdoses. Because of the difficulty of conducting randomized controlled trials, these systematic reviews consist of lower-grade evidence studies throughout. Get the latest research from NIH: https://www.nih.gov/coronavirus. In one study cited within the review, by Walley and colleagues (2013), communities were compared that implemented THKs versus no THKs and their findings indicate decreased overdose deaths in communities with THKs. Practice implications: The following nine criteria are as follows: strength of association, consistency, specificity, temporality, dose-response relationship, plausibility, coherence, experimental evidence, and analogy. A significant limitation of this systematic review is the lack of randomized controlled trials as it is viewed as unethical withholding a known lifesaving medication from an at-risk population. According to Parmar et al. This systematic review focuses on the application of take-home naloxone programs and its association with decreased mortality among those who abuse opioids. COVID-19 transmission: Is this virus airborne, or not? Furthermore, if the entire population of those who use drugs had access to naloxone and associated training programs, one can consider this as the maximum potential lives saved and thus decreased mortality (McAuley et al., 2015). Naloxone THKs have evolved from harm reduction strategies into many community-based programs in the United States, as well as many other countries, to decrease mortality in the growing number of opioid overdoses (McDonald et al., 2017). Increases in drug and opioid-involved overdose deaths-United States, 2010-2015. Although the purpose of this fourth systematic review, "Combating Opioid Overdose With Public Access to Naloxone," is different from the others identified, its results were supportive of overdose education programs and naloxone distribution (Mitchell & Higgins, 2016). Overall, the conclusions of this study are in support of the effectiveness of Scotland's NNP in reducing mortality, cost-effectiveness, and may be beneficial for implementation in other countries. Epub 2016 Mar 30. Drugs: Education, Prevention and Policy, 22(1), 66-76. Data were collected from 2002 to 2009 of 19 communities comparing the implementation of overdose education and nasal naloxone distribution (OEND) programs with high and low implementation with those with no implementation. Because of the overwhelming statistics relayed above in regard to the opioid epidemic and opioid-related deaths (ORDs), a systematic review was undertaken to examine the effectiveness of THKs and their effect in reducing mortality. Morbidity and Mortality Weekly Report, 65(5051), 1445-1452. Methods: A systematic search was conducted in Academic Search Complete, CINHAL, MEDLINE, PsychINFO, and SocINDEX.  |  In 2014, there were 47,055 drug overdose deaths recorded in the United States, and of these, 28,647 had opioids involved (Rudd, Seth, David, & Scholl, 2016). 2016 Jul;111(7):1177-87. doi: 10.1111/add.13326. (2015) systematically examined the existing literature on THN programs, which was determined that there are now sufficient preexisting data to perform a meta-analysis for extrapolation to populations worldwide. COVID-19 is an emerging, rapidly evolving situation. The key … All rights reserved. Limitations exist within the study; one poignant limitation is that THN is not typically used by the person acquiring it, in such that the beneficiaries of the program are not individually identifiable (Bird et al., 2016). 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